Association of Clinical and Radiological Features in Various Repetitive Stress Injuries

Objectives To assess the clinical and radiological features of repetitive stress injuries (RSIs), specifically de Quervain's (DQ) disease, tennis elbow (TE), and plantar fasciitis (PF). Methods This was an observational study conducted for eight months (March 2019 to September 2019) at the Orthopedic Department in collaboration with the Radiology Department. Clinically diagnosed RSI patients from both genders, aged between 30 and 50 years, were included in the study. Clinical features that were considered include pain, swelling, and site of injury. Radiological findings from ultrasound, X-ray, and magnetic resonance imaging (MRI) were identified in all participants of the study. Data were analyzed using SPSS Version 21 (IBM Corp., Armonk, NY, USA). Data were represented as frequency and percentages. Results There were a total of 82 patients (40 males,42 females) with repetitive stress injury (RSI), with a mean age of 42.63 +/- 8.53 years. Of the 82 patients, 34 (41.4%) had DQ disease, 28 (34.1%) had TE, and 20 (24.4%) had PF. Pain and swelling were observed in all patients. In TE, the most affected site was the right lateral epicondyle process. The common radiological findings were hypoechoic fascia, increased fluid within the first extensor tendon compartment, cortical erosion, sclerosis in soft tissues, and calcification in soft tissues. Cozen's test was positive in most patients. In DQ, the most affected sites were left and right radial styloid processes. The common radiological findings were hypoechoic fascia, increased fluid within the first extensor, cortical erosion, and periosteal reaction. Finkelstein's test was also positive in most patients. In PT, the most affected site was the left heal plantar surface. The common radiological findings were hypoechoic fascia, increased thickness of fascia (>4.5 mm), increased fluid within the first extensor tendon compartment, cortical erosion, sclerosis in soft tissues, calcaneal spur, periosteal reaction, and calcification in soft tissues. Cozen's and Finkelstein's tests were also positive in most patients. Conclusions History, physical examination, laboratory findings, and imaging modalities all are important tools for the differential diagnosis of RSI. Our study results showed that if some clinical findings fail to diagnose any RSI, then ultrasound, X-ray, and magnetic resonance imaging (MRI) are the best and useful options before treatment.